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The Face of Courage

One year after nation’s first full face transplant, Dallas Wiens embraces ‘transformation’

By Robin Russell

Perched in a cherry picker while painting the side of a church, Dallas Wiens came in contact with a high-voltage electric power line on Nov. 13, 2008. Struggling to survive, he was airlifted to Parkland Memorial Hospital’s burn unit.

The horrific accident changed his life and his appearance forever – and, incredibly, today he says it’s all for the better.

Dallas Wiens and his dog, Seraph, enjoy some quality time at home in Fort Worth.

Mr. Wiens, now 26, has no recollection of the accident, but he wouldn’t change his three-and-a-half-year journey. He calls the experience a transformation, not a tragedy. And he credits UT Southwestern doctors with getting his life back.

The late Dr. Gary Purdue, UT Southwestern faculty member and longtime head of the Parkland Burn Center, is credited with saving Mr. Wiens’ life, and Dr. Jeffrey Janis, Associate Professor of Plastic Surgery, joined the extraordinarily difficult case.

“Getting him stabilized was the most important thing,” said Dr. Janis, who serves as Chief of Plastic Surgery and Wound Care at Parkland. “Early on, we recognized that this would be different – an extensive, scorching, fourth-degree burn injury down to the bone. It was going to be as challenging a reconstruction as I’ve ever done. He looked like a skull on top of a body.”

The first task after the accident was to remove all the dead tissue from Mr. Wiens’ skull to prevent infection. Amazingly, his brain was fully functional. Doctors kept him in a medically induced coma while they crafted a reconstructive plan.

“This was pretty much uncharted territory,” Dr. Janis said. “Either it would work, or it wouldn’t. We had no backup plan because of the size, extent and nature of the injury.”

Aggressive, strategic strategy

A multidisciplinary team of plastic surgeons, burn surgeons, ophthalmologists, oral surgeons and psychiatrists devised the surgical strategy. In an aggressive microsurgical operation staged over two days, surgeons transferred four muscles from Mr. Wiens’ back and side to his face and neck.

“When we were done, he didn’t even look human,” Dr. Janis said. “His head looked like a swollen mass of unrecognizable tissue. He had no features, no contours, no eye sockets – nothing that resembled a normal face.”

As the swelling started to go down, Dr. Janis began resurfacing Mr. Wiens’ face. After 22 reconstructive surgeries at Parkland, the patient went home. Much of the swelling had subsided, although Mr. Wiens had no facial features except lips.

Everyone thought that was as good as it would get.

In late 2009, however, Dr. Janis was a panelist at a plastic surgery symposium. Another panelist, Dr. Bohdan Pomahac, Assistant Professor of Plastic Surgery at Harvard Medical School, described performing the second partial face transplant in the U.S.

“When we exited the stage, I said to him, ‘I think I’ve got a patient for you,’” Dr. Janis said. “And he replied, ‘I think I can help your patient.’”

Evaluations and tests followed and, a year ago this month, the call came that a donor was available. Mr. Wiens and Dr. Janis were on the next flight to Boston.

The Department of Defense recognized the potential applications of face transplants for injured military veterans and paid for the procedure through a research grant.

Mr. Wiens was more excited than anxious about the surgery. He spoke to the entire surgical team before the historic procedure.

“I expressed my faith in them, and my willingness to go through this procedure. And then I held a group prayer and I told them I’d see them on the other side,” he said.

“He really inspired the whole team,” Dr. Janis recalled.

It took surgeons 14 hours to remove the donor’s face and attach it to Mr. Wiens – carefully stitching together tissue, muscle, blood vessels, glands and nerves.

A ‘handsome’ recovery

Since then, Mr. Wiens has been under the care of Dr. Janis and Dr. Tae Chong, Assistant Professor of Plastic Surgery. The result looks like neither the donor nor the recipient, Dr. Janis said.

The strongest affirmation has come from Mr. Wiens’ daughter, Scarlette, 4. “Daddy, you’re so handsome,” she told him as she touched his face after the transplant.

In subsequent months the physical healing has been remarkable. Mr. Wiens was able to breathe and smell through his new nose just weeks after the face transplant. And he has described his hair growth as “astonishing.”

In September 2011, doctors in Boston fitted him with acrylic eye prostheses. Mr. Wiens remains confident he will see again.

He will have new teeth implanted in June. Though he drinks through a straw, Mr. Wiens is now able to animate his facial muscles and smile. Speech and physical therapy are helping him restore functionality.

Unlike most transplant patients, Mr. Wiens hasn’t had a single episode of tissue rejection. He will be on anti-rejection medication the rest of his life and is checked monthly.

“You’re never out of the woods with a face transplant,” Dr. Janis said.

Still, the success of the procedure represents a new frontier in reconstructive surgery.

“I look pretty normal,” Mr. Wiens said. “The face transplant has given me back my life in a way that prosthetics could not have done. It’s natural skin.”

Mr. Wiens hopes to get a guide dog and even take college classes soon to study computer programming or physics. Thinking back on how he felt when he first heard about the extent of his injuries, Mr. Wiens says he’s come a long way.

“I remember I sat there and thought about it for a long time. When you go through what others consider a tragedy, you have two options: You can either get bitter because of it or you can get better. You can take it and make yourself into something that you know you need to be. And that’s what I decided to do.”

Surprisingly, he says he’s happier now than before the accident.

“I’m content with life. I have wonderful family and friends. And I have my daughter who is the light of my life. I don’t have reason to be pessimistic about anything.

“I can’t take what happened as a tragedy. It’s been a transformation. The future looks bright. It looks fantastic. I can’t wait to see what’s next.”